Am I Being Underprescribed Pain Meds? Options?

[EbolaMonkeyMan]

I was in a car accident about a year ago.  I was at a complete stop waiting to make a turn with my head to the left, when someone, who didn't even see me stopped, slammed into me at between 40-50 mph.  

I have horrible pain in my neck at c6-c7 that radiates down the left arm and into the bottom three fingers on my hand.  I had an MRI that shows a herniated disc at c6-c7.  I went to physical therapy for a few months amounting to 23 visits with little to no help.  

Now starting about 3 months ago the pain got much worse than it had been for the previous 5 months or so since the accident.   I went for a cortisone shot to try to alleviate the problem, but immediately after getting the injection both of my arms were numb, which they said was normal.  That night was the worst night of my life.  I was writhing in pain the entire night, and well into the next day.  

Up until about this time, I was taking 40 mg of oxycodone a day.  I was taking 20 mg at night before bed, and 10 mg in the morning and afternoon.  This was bringing the pain down from a 8-9 to maybe a 6, but that was great compared to what it was without.  Then after being on 40mg a day for 5 weeks the next prescription said to take 10mg before bed and that was it for the day.

Since the drop in meds, at best I sleep every 48 hours.  After being up for 2 days I can sleep a few hours, then repeat the cycle.  They told me that they couldn't prescribe me more oxycodone, or the same as before, because "lots of people in this area abuse it".  

I have been looking and trying to figure out if 40 mg a day was unreasonable for my condition or if I was being stereotyped because of my age or some other reason.  I need some sort of relief and want to make a complaint, but wanted some advice first.

PS. I have an acupuncture appointment next week.  

Thanks,
Jesse  

[Jaybay]

The same thing happened to me years ago and surgery followed by rigorous (and painful) rehab in the form of strengthening exercise took care of it.  If you have nerve root impingement at the site of the herniation, no pain pill on the market will get rid of it.  Neither will anything get rid of the numbness.  Talk to a neurosurgeon and try to keep an open mind about surgery if it's offered

Pain management is all about the "management" and not "cure."  The only thing a doctor can offer is improvement and in some cases even that doesn't amount to much.  I know there are a lot of "failed spinal surgery" stories on this forum, but there are many more people who have had these surgeries and come through just fine.  The folks with good outcomes don't hang out on internet forums.  I'm here for a non-orthopedic problem.  My neck issues are nonexistent now - hallelujah!  :-)

Should you decide to go the surgery route, make sure to have an in-depth discussion with your doctor about post-op rehab.  That's really the most important part of the surgery and something that doctors don't always address with their patients.  I won't lie to you - it hurts.  A lot.  Pain is an unfortunate part of recovery, but it can be managed if you and your doctor are both on the same page with a treatment plan.

[designgyrl]

Have you had any type of MRI or x-rays on your back and neck?  I may have missed it, but I didn't see where they had run any tests to figure out if there was anything

I think the first thing I would do would be to communicate that you are still in pain, and to see where the pain is coming from.  Then when they can run some tests, they can order more physical therapy if needed, or additional medications, surgery, or whatever else may be needed.  If they have done tests and found nothing was showing up on the MRI or x-ray you can always ask for a repeat, because it does seem they are tapering you off the medication.  

Good luck, hope it works out better for you.

[shinty]

I simply believe that a person should be at the dosage that best helps them. I also believe that the dosage should be at the lowest possible for this effect. It's hard to find a doctor who understads pain and it's effects on ones whole life. If you are not abusing or diverting your edications, I see no reason not to be prescribed ANY needed dosage - high or low. Good luck fnding a doctor with the same thought process though!

[mscynthia1969]

Sometimes these injuries need surgery.  Oxycodone is frequently abused and sold by some patients.  The doctors are being cautious for them and for you.  Their liability and your health.  Unfortunately whats best for your health isn't always whats best for cronic pain.  Oxycodone is very addictive and patients can become addicted without even realizing it.  You definitely need to address the cronic pain issue and the spinal issue.  I would see a specialist to get more direction.  Also, communicate with your doctor when you are on long-term monthly medications.  Don't change Dr.s frequently or Pharmacies.  It increases their concerns and makes them worry that you might be shopping for doctors.  I hope you work it out.  A specialist is your best bet.

[Tuckamore]

Hi Jesse,

Welcome to the Pain Management Forum. I am glad that you found us at MedHelp and took the time to provide us with an informative post.

In my opinion 40mg is not a huge dose of oxycodone. Unfortunately the DEA is all over some of our physicians to reduce and/or not prescribe opiates for non-terminal patients. I am guessing this is the reason your physician reduced the amount of your oxycodone.

We seem to be moving backwards, not forward in pain management, again my opinion. The regulations are tightening on our physicians.....because of the abuse that is so rampant in our country. The results are that ppl like you and I that do have legitimate pain suffer.

But it's not all bleak. There are physicians that will and do percribe for their chronic pain patients. In many areas/states these are usually PMP. You may require a consult with a PMP. I would ask your current physician for a referral. Explain to him that your pain is not being adequately controlled. We all know that we will never be pain free....but we should not have pain on a daily bases that is an 8 or above.  

Please keep in touch and let us know how you are doing. We are here to offer our support. I'll look forward to hearing from you again soon. Best of luck to you!

Peace,
~Tuck